The deadly gulf between NHS managers and the reality of patient care

The Mid Staffordshire scandal

SIR – In 2011, Sir David Nicholson told the Francis inquiry that Mid Staffordshire was a “singular” problem and not the result of “systematic” failure by the NHS.

That opinion – demolished this week by the Francis report – shows a cavernous gulf between the views of senior NHS management and the reality for patients, their families and hospital staff across the country.

Not only did Sir David preside over the disaster at Mid Staffordshire, he allowed the same systemic problems to prevail in the wider NHS. Many have suffered as a consequence and, sadly, many have died.

Just weeks before Sir David described Mid Staffs as a singular failure, the Care Quality Commission published results from a damning inspection of maternity services at Morecambe Bay NHS trust. It found six essential standards were not being met and highlighted “major concerns” with staffing levels, risk management and teamwork.

Three years earlier, in 2008, those very issues had led to the unnecessary death of my son, Joshua, at nine days old. Between 2008 and 2011 they were not sufficiently addressed.

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Indeed, the Dr Foster unit at Imperial College, London, calculates that in that time at least 500 more deaths than expected occurred at hospitals run by the Morecambe Bay trust.

Subsequent investigations found a “damning state of care” there, including A&E patients fainting from pain during seven-hour waits.

Robert Francis warned that Mid Staffs could be repeated elsewhere in the NHS. It has been. We deserve more than this and I firmly add my voice to those calling for Sir David’s immediate resignation.

James Titcombe Dalton-in-Furness, Cumbria

SIR – Does anyone know what Sir David Nicholson did to get his knighthood?

Dr Paddy Fielder Woodbridge, Suffolk

SIR – I deplore what happened at Mid Staffordshire. However, I would like to mention my own experience of the NHS.

Last summer my husband spent seven weeks, until his death, in an acute ward of the John Radcliffe Hospital in Oxford. The care and kindness shown to him (at times a quite difficult patient) were outstanding. It helped my family and me greatly and I have nothing but praise for the doctors and nurses on that ward.

We rarely seem to hear praise when things do work well.

Linda Mascaro Buckland, Oxfordshire

SIR – As a trade union and professional organisation, the Royal College of Nursing has no powers to inspect or regulate standards of care (Leading article, February 8). The RCN is the voice of nursing and nursing staff.

The power to investigate and take action for poor care rests with the Nursing and Midwifery Council.

The RCN has been clear: if members see any examples of poor care, it is their duty to raise them. The RCN will never defend examples of poor care and any nurse guilty of mistreatment must be held to account.

Dr Peter Carter Chief Executive & General Secretary Royal College of Nursing London W1

SIR – I was told that the NHS is the envy of the world. God help the rest of the world.

Jeremy Taylor Rye, East Sussex

Horse dressed up as beef

SIR – All owners were compelled to register their horses with the Horse Passport Agency a few years ago. This was to ensure that no horse meat entered the food chain contaminated with drugs.

No owner that I know would allow their horse to go for slaughter, so this was all just a waste of time and money as far as we were concerned.

Horse passports have to be updated every time a horse is given drugs, as with annual vaccinations for flu and tetanus. Passports must be carried at all times when travelling with horses to events.

With the current revelations of horse meat in so-called beef products it seems that passporting is irrelevant.

Angela Davey Binfield, Berkshire

SIR – The tough lesson from finding horse in ready meals is that Britain has become lazy in not making meals from scratch.

Not buying good meat at the local butcher has caused fine shops to close down. Furthermore, a butcher would give advice as to which cut of meat is suited to a particular recipe.

Lack of parental teaching on how to shop and cook is becoming an inherited ignorance in many homes.

Angela Walters Princes Risborough, Buckinghamshire

SIR – It is a good time to ensure that retailers mark food as British, not when it is just packed in Britain, but bred and grown here.

G G Garner Ravensden, Bedfordshire

SIR – Aversion to eating horse meat has nothing to do with safety. It stems essentially from the same reason as our aversion to eating dog meat. Horses and dogs have, for millennia, been our workmates and companions.

Michael Forrest Bridport, Dorset

Goodbye to post offices

SIR – The main post office in Bromley, Kent, was relocated to a nearby branch of W H Smith some time ago, and the building now houses two restaurants.

If the largest borough in Greater London cannot keep its post office, what hope is there for small rural communities or even sizeable provincial towns?

John Carter Shortlands, Kent

SIR – On Tuesday I went to renew my driving licence at my local main post office. They processed the paperwork, took my photograph and electronically sent this to the DVLA.

On Friday, I received my new licence. Excellent service.

Nick Parry High Wycombe, Buckinghamshire

Hitchnock

SIR – Far from resembling the great film director in Sacha Gervasi’s film Hitchcock (Arts, February 8), Anthony Hopkins seems to have been wearing the Spitting Image mask of his compatriot Neil Kinnock.

Roland Joy Hartwell, Northamptonshire

Make wicked pot legal

SIR – Your report of my remarks about drugs (February 8), though accurate, failed to mention that I was arguing for the legalisation of cannabis.

I believe legalisation would stop driving soft-drug users into the hands of criminal gangs who will try to lure them on to hard drugs.

This view does not arise from any desire to encourage cannabis use. The fact that something is legal does not automatically make it morally or socially desirable. Adultery is legal but wrong.

Sadly, because of the contemporary taboo against mentioning the morality of any form of behaviour, the case for banning the sale of cannabis is made to rest solely on health risks, often exaggerated and even spurious.

When these are discredited, it undermines the authority of the law and leaves parents and teachers without a moral case to discourage drug abuse.

Peter Lilley MP (Con) London SW1

Embarrassing committee

SIR – I was embarrassed to hear that the thing uppermost on the Treasury Select Committee’s mind when it met Mark Carney, the incoming Governor of the Bank of England, was not monetary policy or economic growth, but how much he was going to cost.

The line of questioning was petty and demeaning and showed our country in a poor light. If this is the best the committee can do, we have little chance of recovery.

Paul Selway-Swift Upper Pendock, Worcestershire

Scunny uplands

SIR – Samantha Cameron could prove her home town Scunthorpe is not the least romantic place in Britain (Leading article, February 7) by taking her husband there on St Valentine’s Day.

A candlelit dinner in the excellent Colosseo Italian restaurant could be followed by a stroll in the gentle hills just north of town with beautiful views across the Trent valley towards the Isle of Axholme where John Wesley spent his early childhood… if only her father hadn’t spoilt them with a wind farm.

Michael Powell Tealby, Lincolnshire

Bring back King Richard to his wife’s side

SIR – Westminster Abbey seems most appropriate for King Richard III, close to his wife, Anne Nevill, who predeceased him on March 16, 1485.

A few years ago the Richard III Society commissioned an enamelled plaque with her coat of arms to be affixed close to her burial site in the Abbey.

Henry VII, who showed scant respect for Richard’s body, now lies in great splendour alongside his wife, Elizabeth of York, Richard’s niece. Surely now is the time to reunite Queen Anne with her husband, and in the place where they were both crowned.

Patrick Pilkington Coole, Co Westmeath, Ireland

SIR – Calls in your Letters page for Richard III to be reburied in York Minster, because he was a Yorkist, or in a Roman Catholic church because he was a Roman Catholic are both misconceived.

First, titles should not be confounded with geography. York was the headquarters and chief stronghold of Richard’s Lancastrian enemies.

London was to the Yorkists what York was to the Lancastrians.

Secondly, Richard III was Church of England, which at that time was in communion with the Bishop of Rome. Currently it is not. That is all.